THE GLOBAL CHALLENGE OF IODINE DEFICIENCY

John T. Dunn

Iodine deficiency affects most of the world’s land mass, and consequently puts a large part of the population at risk. The most damaging effects are increased neonatal mortality and retarded brain development, but others are important, including goiter, hypothyroidism, and socioeconomic deprivation. Several good means are available for correcting iodine deficiency, the best being iodized salt; iodized vegetable oil, iodized water, and iodine tablets have an occasional place as well. Major components of successful IDD control include an effective national program, usually in the Ministry of Health, a national advisory commission that represents all sectors involved with iodine deficiency and its correction, a vigorous education and communication program, and regular and reliable monitoring both of people and of iodized salt. Currently 2.2 billion of the world’s population are considered at risk for iodine deficiency and its consequences. Overall, about 70% of households consume iodized salt. Only about 20% of the affected countries have adequate monitoring of people, by urinary iodine concentration, or of iodized salt. The major needs now are promoting adequate iodine nutrition in the countries that are still deficient and sustaining achievements of those that are now sufficient. While progress in the last decade has been outstanding, much remains to be done. By maintaining the current momentum, we can reach the virtual elimination of iodine deficiency worldwide, as pledged by the World Summit of Children in 1990.